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Systematic Review

Evidence Map and Systematic Review of Disinfection Efficacy on Environmental Surfaces in Healthcare Facilities

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The Water Institute, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
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ICF, Durham, NC 27713, USA
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Health Sciences Library, University of North Carolina, Chapel Hill, NC 27599, USA
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School of Civil Engineering, University of Leeds, Leeds LS2 9DY, UK
*
Author to whom correspondence should be addressed.
Academic Editor: Paul B. Tchounwou
Int. J. Environ. Res. Public Health 2021, 18(21), 11100; https://doi.org/10.3390/ijerph182111100
Received: 29 September 2021 / Revised: 19 October 2021 / Accepted: 20 October 2021 / Published: 22 October 2021
Healthcare-associated infections (HAIs) contribute to patient morbidity and mortality with an estimated 1.7 million infections and 99,000 deaths costing USD $28–34 billion annually in the United States alone. There is little understanding as to if current environmental surface disinfection practices reduce pathogen load, and subsequently HAIs, in critical care settings. This evidence map includes a systematic review on the efficacy of disinfecting environmental surfaces in healthcare facilities. We screened 17,064 abstracts, 635 full texts, and included 181 articles for data extraction and study quality assessment. We reviewed ten disinfectant types and compared disinfectants with respect to study design, outcome organism, and fourteen indictors of study quality. We found important areas for improvement and gaps in the research related to study design, implementation, and analysis. Implementation of disinfection, a determinant of disinfection outcomes, was not measured in most studies and few studies assessed fungi or viruses. Assessing and comparing disinfection efficacy was impeded by study heterogeneity; however, we catalogued the outcomes and results for each disinfection type. We concluded that guidelines for disinfectant use are primarily based on laboratory data rather than a systematic review of in situ disinfection efficacy. It is critically important for practitioners and researchers to consider system-level efficacy and not just the efficacy of the disinfectant. View Full-Text
Keywords: disinfection; healthcare facilities; healthcare-associated infections; environmental surfaces; infection prevention and control disinfection; healthcare facilities; healthcare-associated infections; environmental surfaces; infection prevention and control
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MDPI and ACS Style

Christenson, E.C.; Cronk, R.; Atkinson, H.; Bhatt, A.; Berdiel, E.; Cawley, M.; Cho, G.; Coleman, C.K.; Harrington, C.; Heilferty, K.; Fejfar, D.; Grant, E.J.; Grigg, K.; Joshi, T.; Mohan, S.; Pelak, G.; Shu, Y.; Bartram, J. Evidence Map and Systematic Review of Disinfection Efficacy on Environmental Surfaces in Healthcare Facilities. Int. J. Environ. Res. Public Health 2021, 18, 11100. https://doi.org/10.3390/ijerph182111100

AMA Style

Christenson EC, Cronk R, Atkinson H, Bhatt A, Berdiel E, Cawley M, Cho G, Coleman CK, Harrington C, Heilferty K, Fejfar D, Grant EJ, Grigg K, Joshi T, Mohan S, Pelak G, Shu Y, Bartram J. Evidence Map and Systematic Review of Disinfection Efficacy on Environmental Surfaces in Healthcare Facilities. International Journal of Environmental Research and Public Health. 2021; 18(21):11100. https://doi.org/10.3390/ijerph182111100

Chicago/Turabian Style

Christenson, Elizabeth C., Ryan Cronk, Helen Atkinson, Aayush Bhatt, Emilio Berdiel, Michelle Cawley, Grace Cho, Collin K. Coleman, Cailee Harrington, Kylie Heilferty, Don Fejfar, Emily J. Grant, Karen Grigg, Tanmay Joshi, Suniti Mohan, Grace Pelak, Yuhong Shu, and Jamie Bartram. 2021. "Evidence Map and Systematic Review of Disinfection Efficacy on Environmental Surfaces in Healthcare Facilities" International Journal of Environmental Research and Public Health 18, no. 21: 11100. https://doi.org/10.3390/ijerph182111100

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